Adam's Heart Valve Surgery Blog – Page 40

One trend I’ve noticed over the years is that surgeons and cardiac centers are becoming “sub-specialists” specific to heart valve treatment. By sub-specialization, I mean that clinics are extending significant resources to advance valvular therapy by disease type, by surgical technique and by patient risk factors. For example, three weeks ago, I met with a surgeon who suggested that 99% of his procedures are mitral valve repairs.

Last Monday, the trend to “sub-specialization” became more apparent when Chicago-based Northwestern Memorial Hospital launched a dedicated Bicuspid Aortic Valve Program within its distinguished Bluhm Cardiovascular Institute.

Prior to learning about Northwestern’s BAV program, I knew that a handful of surgeons and cardiac centers specialized in bicuspid aortic valve treatment.  However, I had yet to hear of a complete, end-to-end program dedicated to bicuspid aortic valve disease — a disorder that impacts 1%-2% of the population.

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This morning, I received a great email from Vicki which reads, “Hi Adam – Is mitral stenosis the same thing as a leaking heart valve?”

I think Vicki’s question is excellent because many patients are often confused when we attempt to understand the medical terms used during our appointments with primary care physicians, cardiologists and surgeons. Personally, I only understood 10% of the medical terms the cardiologist used to explain my severe aortic stenosis diagnosis.

Mitral Valve Stenosis

That said, the answer to Vicki’s question is… No, mitral stenosis is not the same thing as a leaking heart valve disorder.

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For those patients and caregivers preparing for — or recovering from — heart valve surgery, I wanted to quickly share that the 2012 edition of my book, The Patient’s Guide To Heart Valve Surgery, is now available. This 5th revision includes several updates and contributions from leading physicians like Dr. McCarthy, Dr. Bolling, Dr. Adams, Dr. Stewart, Dr. Gaudiani, Dr. Roselli and more.

As you can see below, Robyn (my wife) and Ethan (my son) helped me pack up our first shipment of books that were just dropped off at the post office.

Ethan & Robyn Help Me Pack Up The New 2012 Edition

I’m hopeful the book helps guide you and those around you through heart valve surgery.

• If you would like to order the new edition, please click here.

Keep on tickin!
Adam

I’m very happy to announce that Keck Hospital of USC just launched a ‘Heart Valve Clinic Microsite’ at HeartValveSurgery.com!

You will find USC’s microsite in the new valve clinics directory of our website. There, you can learn about USC’s approach to heart valve surgery, its surgeon team, including Dr. Vaughn Starnes, my surgeon, and our patient success stories. To see the microsite, click here.
 

USC Heart Valve Clinic Microsite

Thanks to Dr. Vaughn Starnes, Dr. Craig Baker, Julie Starnes, Sherry Whitney and the entire USC team for their continued support of the patients and caregivers within our community.

Keep on tickin!
Adam

To all of our patients and caregivers from the USA… Happy 4th of July!!!

Robyn (my wife) & Ethan (my son)

Robyn, Ethan & I hope you enjoy all the special elements of this holiday including barbecues, hot dogs, family get togethers, hamburgers, cole slaw, pool parties, corn, vacations, apple pie, parades, s’mores, fireworks and, most importantly, freedom.

Keep on tickin!
Adam

In addition to talking with patients, I’m often afforded the privilege of speaking with their caregivers. Over the past several months, I’ve been trading emails and chatting on the phone with Deb. Her husband, Fred, was recently diagnosed with a severely leaking mitral valve.

Deb & Fred (Mitral Valve Repair Patient)

The great news is that Fred’s surgery went very well. In fact, he’s already back on the golf course.

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It continues to amaze me how Heart Valve Journals is connecting patients online and offline.

This time, Tom Hunt and Trent Viavattene met at The Heart Hospital in Plano, Texas. The two were simultaneously admitted to The Heart Hospital last week. Trent had a mitral valve repair surgery with Dr. William Ryan.

Trent & Tom at The Heart Hospital

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Great news everybody!

Northwestern Memorial Hospital from Chicago, Illinois just launched a new ‘Heart Valve Clinic Micrsoite’ at our website. Using this technology, you can go on a virtual tour of Northwestern, watch surgeon videos, download surgical outcomes, see patient stories and much more. To experience it, click here.

Needless to say, we are thrilled and honored to launch Northwestern’s microsite.

Thanks to the entire Northwestern team for its ongoing support of our community. And, most importantly, thanks to Drs. McCarthy, Malaisrie, Russell, Jane and Colleen for the excellent care they collectively provide to our patients and caregivers!

Keep on tickin!
Adam

Over the years, I have been fortunate to meet several extraordinary patients. One such patient is Kato Pomer from Los Angeles, California.

As you might recall from my first post about Kato, she suffered from severe mitral regurgitation that progressed incredibly quick. Considering her age and other factors, Kato’s only hope for treatment was the MitraClip transcatheter valve repair. Thankfully, the team at Cedars-Sinai Medical Center — which included Dr. Karr, Dr. Trento and Dr. Shah — performed a MitraClip procedure. Kato was 92 years old at the time of the operation.

Today, Kato is celebrating her 95th birthday. Yeaahhhhh!!! Reflecting upon her procedure, Kato had the following message to share with her doctors, fellow patients and the FDA about the MitraClip.

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I just learned that Max Page, the 7-year old actor who played ‘Little Darth Vader’ in a viral Volkswagen commercial, is recovering from pulmonary heart valve replacement surgery.

It turns out that Doctor Vaughn Starnes, my cardiac surgeon, from USC Medical Center and Children’s Hospital of Los Angeles, replaced the pulmonary valve, which was diagnosed as a congenital defect when Max was just 3 months old.

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Tanya just sent me a very interesting question about heart valve replacement surgery.

She writes, “Hi Adam – I’ve been diagnosed with a narrow aortic valve at .6 centimeters. I’m currently debating between a mechanical and tissue valve replacement. I’m curious to know how the surgeons get the valves. Do the hospitals order the replacement valves before the surgery? Or, are the valve replacements stored at the hospital? Thanks, Tanya”

I don’t know how all hospitals manage this process but I’ve been fortunate to tour a few cardiac centers that specialize in heart valve treatment. Each one of these centers kept their heart valve replacement devices on-site, ready for implant. More specifically, the devices were stored in large, protected drawers. As you can see, this is a picture of the ‘St. Jude Medical’ drawer I photographed during a recent visit to the Cleveland Clinic.

St. Jude Heart Valve Replacement Drawer at Cleveland Clinic

It’s also interesting to note that certain heart valve replacements are stored at very low temperatures to preserve the integrity of the tissue. For example, the Cryolife homografts (human donor valve replacements) are typically stored at or below freezing prior to implant.

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I just received a great email from James about the Ross Procedure and a diseased bicuspid aortic valve.

James writes, “Hi Adam – I’m 47 and recently told I need to replace my bicuspid aortic valve due to stenosis. Through your website, I’ve learned about the Ross Procedure as an option for me. It sounds interesting but I’m curious to know if the Ross Procedure can be used for my bicuspid aortic valve? Thanks, James”

Ross Procedure Diagram & Bicuspid Aortic Valve Picture

Typically, for technical questions about heart valve repair and heart valve replacement operations, I contact our cardiac surgeon team for their opinions on patient questions. Luckily, for this question, I can provide James a direct response.

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The possibility of aortic valve replacement without an incision to the sternum or ribs of the patient has become a reality for select patient categories. Together, our community has followed the evolution of catheter-based technologies including the SAPIEN heart valve replacement by Edwards Lifesciences which received FDA approval for “inoperable” patients last year. Needless to say, patient interest specific to this and other transcatheter devices, including the CoreValve and the MitraClip, is significant.

SAPIEN Heart Valve Replacement (Edwards Lifesciences)

For that reason, I wanted to make sure you were aware of a recent announcement in which an FDA panel recommended the SAPIEN heart valve replacement for wider use among “high-risk” aortic stenosis patients. So you know, a “high risk” patient is healthy enough to have surgery but faces serious health risks because of age (often greater than 80 years old) or illnesses (like diabetes).

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In 2008, when I first spoke with Doctor David Adams, the Chairman of Cardiothoracic Surgery at The Mount Sinai Medical Center, he immediately understood the key objective of this website – to educate and empower patients from diagnosis through recovery. Over the years, Dr. Adams’ support of this project has been extraordinary and, most importantly, Dr. Adams has performed successful surgery on many patients in our community. As you can see at his profile page, Dr. Adams has 25 patients testimonials in our Surgeon Finder.

Today, I’m happy to announce that Dr. Adams and The Mount Sinai Medical Center launched a ‘Heart Valve Clinic Microsite’ at HeartValveSurgery.com.

Now, patients and caregivers in our community can quickly learn about Mount Sinai’s unique approach to valvular treatment, its surgical outcomes, its team of cardiac surgeons, patient success stories, and more. To visit the microsite, simply click here.

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I wanted to shine our “Heart Valve Journals Spotlight” on Trent Viavattene, a mitral regurgitation patient from Plano, Texas.

So you know, Trent is preparing for mitral valve surgery to be performed next Monday by Dr. William Ryan. I could ramble on about Trent, his wife (Amanda) and his two boys (Riley and Jake). Instead, I’d encourage you to visit Trent’s journal and, perhaps, leave him an encouraging note at his guestbook.

Trent, Riley & Jake

Personally, I was inspired to learn that Trent recently met up with Thomas Hunt, another patient from Texas, who just had mitral valve surgery with Dr. Gillinov at the Cleveland Clinic.

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Thanks to everybody for your ongoing inquiries about Ethan, our 3-year old son.

Since the last update, Ethan has developed a passion for the performing arts. Actually, it’s less of a passion and more of a rampant addiction. It started with him imitating, role-playing and singing the songs from Yo Gabba Gabba. Then, it progressed to the Mickey Mouse Clubhouse.

Ethan as Mickey Mouse

After the Mickey Mouse Clubhouse ran its course, Jake and the Neverland Pirates became his favorite “show” to perform. After Jake, it was Handy Manny, then the Muppets and… the list goes on.

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I just received an interesting email from Steve about the time in which the heart is iced and stopped during heart valve replacement and heart valve repair surgery.

In his email, Steve writes, “Hi Adam – I am having mitral valve repair surgery next month. One glaring question… I’ve read that when the heart is stopped it is “iced” and therefore can last 2-4 hours without tissue damage.  However, a whole bunch of these surgeries take between 4-7 hours, sometimes more. How do we reconcile the discrepancy? Thank you, Steve”

Ice Chips On Heart During Cooling Process

Steve raises a great question. For that reason, I contacted Dr. Marc Gillinov to get a great answer. If you were unaware, Dr. Gillinov is a staff surgeon at the Cleveland Clinic, co-author of Heart 411 and a super nice guy.

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Hi everybody,

I wanted to take a quick moment to share that Dr. Randolph Chitwood, Director of the East Carolina Heart Institute, has been named our current ‘Featured Heart Valve Surgeon’.  In addition to being a pioneer and innovator in the field of cardiac surgery, Dr. Chitwood has been an incredible supporter of the patients and caregivers within our community — including Richard, Nick, Rodney and Amy.

To help you learn more about Dr. Chitwood and his unique approach to cardiac care, here are two interesting links:

• Heart Valve Clinic Tour: Keeping up with Dr. Chitwood
• First-In-Man Implant of ValveXchange performed by Dr. Chitwood and Dr. Svensson

Lastly, if you would like to see Dr. Chitwood’s surgeon profile, video and patient testimonials, please click here.

Keep on tickin’ Dr. Chitwood!
Adam

I recently received a question from Randy about his teenage daughter who requires surgery due to a leaking aortic valve.

In his email, Randy writes, “Hi Adam – My daughter, Haley, has severe aortic valve regurgitation.  She is 14-years old and was diagnosed at age 9.  She is asymptomatic but conditions have progressed to a point where surgery is warranted. My wife and I are struggling with choosing the right procedure.  Our medical team has recommended valve repair first and valve replacement second.  Based on all information gathered to this point, we are leaning towards mechanical valve replacement for Haley. What do you think? Thanks, Randy”

I wanted to provide Randy an expert opinion, so I contacted Dr. Fayyaz Hashmi from Mercy Health System in Toledo, Ohio. I recently met Dr. Hashmi at the Heart Valve Summit. Beyond being a very experienced surgeon, with over 10,000 procedures completed, Dr. Hashmi is a very kind, soft-spoken man with an altruistic and global approach to cardiac care.

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There are no words for what you are about to see… For what is about to occur…

To learn more about ‘Flatline to Finish’ and how you can support this extraordinary effort, please click here. Go Dave!

Go Iron Heart Racing Team!

Adam